Commentary: Psychiatric Training for Physicians: A Call to Modernize

Abstract

Genetics and the neurosciences are changing the knowledge base of psychiatry. The authors of this commentary argue that if psychiatry is to meet the considerable challenges associated with assimilating the rapid advance of those sciences and populating the field with new leaders who will contribute to such advances, fundamental problems in psychiatric education and training must be addressed. The authors argue that three domains in particular require change--an overemphasis on the outmoded diagnostic system, a residual attachment to archaic psychoanalytic constructs, and an unwarranted confidence in current therapeutic capabilities. They then propose first steps aimed at remedying each domain. The authors suggest increased curricular emphasis on taxonomic approaches distinct from that of the current Diagnostic and Statistical Manual of Mental Disorders system, enhanced attention to and teaching of core cognitive neuroscientific concepts, and a concerted emphasis on the development of skills needed for critical evaluation of the empiric bases of therapeutics. They conclude that progress in psychiatry requires that educators shift their emphases toward what is currently known and being learned--including the scientific sophistication needed to assess such claims of knowledge--and away from taxonomic and conceptual systems that are demonstrably flawed, if not simply wrong.